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Breast reconstruction with a dermal sling : a systematic review of surgical modifications

Hansson, Emma LU ; Jepsen, Christian and Hallberg, Håkan (2018) In Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00
Abstract

A dermal sling (DS) is used to cover the implant with two layers of tissue when immediate breast reconstruction is performed in women with large and ptotic breasts. It works as an autologous acellular dermal matrix/mesh that can be used to control the implant pocket and inframammary fold, without inferring an extra foreign material and higher costs. There is relatively little published about the DS technique. The primary aim of this study was to systematically review published surgical modifications to the dermal sling (DS). The secondary aim was to investigate what implants have been used. Relevant databases were searched for articles and abstracts published between January 1990 and September 2018. Inclusion criteria were studied and... (More)

A dermal sling (DS) is used to cover the implant with two layers of tissue when immediate breast reconstruction is performed in women with large and ptotic breasts. It works as an autologous acellular dermal matrix/mesh that can be used to control the implant pocket and inframammary fold, without inferring an extra foreign material and higher costs. There is relatively little published about the DS technique. The primary aim of this study was to systematically review published surgical modifications to the dermal sling (DS). The secondary aim was to investigate what implants have been used. Relevant databases were searched for articles and abstracts published between January 1990 and September 2018. Inclusion criteria were studied and case reports on DS meeting the criteria defined in a PICO. Review articles were excluded. Total evidence for the different types of DSs was graded according to GRADE. A total of 428 abstracts were retrieved. Of these 373 abstracts did not meet the inclusion criteria and were excluded, leaving 54 abstracts. Nine categories of surgical modifications could be identified: classic dermal sling (DS) with minor modifications, non Wise-pattern mastectomy DS, nipple areola complex bearing DS, DS in combination with a matrix/mesh, DS as a suture line protection technique, DS with a modified circulatory basis, DS without an implant, DS as an immediate-delayed technique and pre-pectoral DS. The evidence for DS as a surgical technique is very low (GRADE ⊕). The DS can be used with both permanent implants and tissue expanders (GRADE ⊕).

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organization
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Contribution to journal
publication status
epub
subject
in
Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00
pages
12 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85058704657
ISSN
2000-656X
DOI
10.1080/2000656X.2018.1533840
language
English
LU publication?
yes
id
d02100bc-001e-4278-be79-eb833a647f60
date added to LUP
2018-12-25 12:27:49
date last changed
2019-01-08 12:17:45
@article{d02100bc-001e-4278-be79-eb833a647f60,
  abstract     = {<p>A dermal sling (DS) is used to cover the implant with two layers of tissue when immediate breast reconstruction is performed in women with large and ptotic breasts. It works as an autologous acellular dermal matrix/mesh that can be used to control the implant pocket and inframammary fold, without inferring an extra foreign material and higher costs. There is relatively little published about the DS technique. The primary aim of this study was to systematically review published surgical modifications to the dermal sling (DS). The secondary aim was to investigate what implants have been used. Relevant databases were searched for articles and abstracts published between January 1990 and September 2018. Inclusion criteria were studied and case reports on DS meeting the criteria defined in a PICO. Review articles were excluded. Total evidence for the different types of DSs was graded according to GRADE. A total of 428 abstracts were retrieved. Of these 373 abstracts did not meet the inclusion criteria and were excluded, leaving 54 abstracts. Nine categories of surgical modifications could be identified: classic dermal sling (DS) with minor modifications, non Wise-pattern mastectomy DS, nipple areola complex bearing DS, DS in combination with a matrix/mesh, DS as a suture line protection technique, DS with a modified circulatory basis, DS without an implant, DS as an immediate-delayed technique and pre-pectoral DS. The evidence for DS as a surgical technique is very low (GRADE ⊕). The DS can be used with both permanent implants and tissue expanders (GRADE ⊕).</p>},
  author       = {Hansson, Emma and Jepsen, Christian and Hallberg, Håkan},
  issn         = {2000-656X},
  language     = {eng},
  month        = {12},
  pages        = {12},
  publisher    = {Taylor & Francis},
  series       = {Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00},
  title        = {Breast reconstruction with a dermal sling : a systematic review of surgical modifications},
  url          = {http://dx.doi.org/10.1080/2000656X.2018.1533840},
  year         = {2018},
}